Individual provider Active NPI

Mary Elizabeth Katinas, NP

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1992282099
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382890 Issued in NY
Practice address
161 Fort Washington Ave
New York, NY 10032-3729
Phone
(212) 305-5868
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382890 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave
New York, NY 10032-3729

Mailing address

3959 Broadway # 8Central
New York, NY 10032-1559
Phone (212) 305-5919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220203002306 NY Practitioner - Nurse Practitioner 4587057146 Reassigns benefits to 1 organization
I20250921000091 DC Practitioner - Nurse Practitioner 4587057146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Nov 19, 2021 Accepting new patients
Children'S Hospital CurrentSince Aug 22, 2025 Accepting new patients
Children'S Hospital CurrentSince Aug 22, 2025 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Nov 19, 2021 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

3959 Broadway
#8
New York, NY 10032

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: mak9165@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1992282099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY # 8CENTRAL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATINAS",
        "first_name": "MARY ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.